血清糖类抗原19-9、癌胚抗原在壶腹周围癌中的诊断和预后价值

目的 :观察壶腹周围癌病人术前血清 CA 19- 9和 CEA水平 ,探讨 CA19- 9和 CEA诊断壶腹周围癌的敏感性 ,预后价值。方法 :回顾性分析 130例经手术证实的壶腹周围癌病例 ,术前 1周内测量血清 CA19- 9和 CEA水平 ,比较病人血清 CA19- 9、CEA诊断敏感性 ,术后随访为 2～ 6 3个月 ,在全部病例及切除病例中分别评价血清 CA19-9、CEA阳性和阴性的预后。结果 :壶腹周围癌 5 9例切除 ,71例未能切除。CA19- 9检测壶腹周围癌阳性率为 81.5 4 % ,而 CEA阳性率为 2 9.2 3% ,两者比较差异有显著性 (P<0 .0 5 )。全部病例中 CA19- 9阳性者中位生存期 11个月明显短于 CA19- 9阴性者 32个月 (P<0 .0 5 )。同样 ,CEA阳性者中位生存期 6个月明显短于 CEA阴性者 17个月 (P<0 .0 5 )。结论 :CA19- 9比 CEA能提供更重要的诊断和预后价值 ,血清 CA19- 9在检测壶腹周围癌 ,评价切除性和预测预后方面可作为重要的辅助检查

Diagnostic and prognostic values of CA19-9 and CEA in periampullary cancers

Objective:To assess the value of serum CA19 9 and CEA in the diagnosis and prognosis of periampullary cancers.Methods:Preoperative serum levels of CA19 9 and CEA, and clinicopathologic features were retrospectively reviewed in 130 surgical patients with periampullary cancer.Results:There were 59 resectable and 71 unresectable periampullary cancers. CA19 9 demonstrated significantly higher sensitivity in detecting these cancers (81.54%) than CEA (29.23%) . CA19 9 was a significant prognostic factor.Marked elevation of serum CA19 9, but not CEA, tended to associate with advanced and unresectable periampullary cancers.Conclusion:Serum CA19 9 provided more important diagnostic and prognostic values than CEA in periampullary cancers.Serum CA19 9 is recommendedas an adjunct in detecting periampullary cancers ?in evaluating respectability and in predicting prognosis.